Health Information Management

Q&A: Did CMS add any pass-through drugs for October?

APCs Insider, September 4, 2015

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Q: Will CMS be adding any new drugs or biologicals to its pass-through list in its next OPPS update?
A: Yes, CMS is adding two newcodes effective October 1:
  • C9456, injection, isavuconazonium sulfate, 1 mg
  • C9457, injection, sulfur hexafluoride lipid microsphere, per ml
Code C9456 has been assigned to APC 9456 and C9457 has been assigned to APC 9457. Both have been assigned status indicator G (additional payment for drug/biological pass-through).
Editor’s note: Denise Williams, RN, CPC-H, seniorvice president of revenue integrity services at Revant Solutions, formerly known as Health Revenue Assurance Associates, Inc., in Fort Lauderdale, Florida, answered this question.

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